Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Medicine, Albert Einstein College of Medicine, New York, New York, USA.
Clin Transplant. 2024 Sep;38(9):e15454. doi: 10.1111/ctr.15454.
The number of living kidney donors in the United States has declined since 2005, with variations based on the donor-recipient relationship. The reasons for this decline are unclear, and strategies to mitigate declined donations remain elusive. We examined the change in donor number monthly (within-year) versus annually (between-years) to inform potentially modifiable factors for future interventions.
In this registry-based cohort analysis of 141 759 living kidney donors between 1995 and 2019, we used linear mixed-effects models for donor number per month and year to analyze between-year and within-year variation in donation. We used Poisson regression to quantify the change in the number of donors per season before and after 2005, stratified by donor-recipient relationship and zip-code household income tertile.
We observed a consistent summer surge in donations during June, July, and August. This surge was statistically significant for related donors (incidence rate ratio [IRR] range: 1.12-1.33) and unrelated donors (IRR range: 1.06-1.16) across donor income tertiles.
Our findings indicate lower rates of living kidney donation in non-summer months across income tertiles. Interventions are needed to address barriers to donation in non-summer seasons and facilitate donations throughout the year. Since the Organ Donor Leave Law provides a solid foundation for supporting year-round donation, extending the law's provisions beyond federal employees may mitigate identified seasonal barriers.
自 2005 年以来，美国活体肾脏捐献者的数量有所下降，其变化基于供受者关系。这种下降的原因尚不清楚，减轻捐赠减少的策略仍然难以捉摸。我们检查了每月（年内）与每年（年际）的供体数量变化，以了解未来干预措施的潜在可改变因素。
在这项基于登记的队列分析中，我们分析了 1995 年至 2019 年间的 141759 名活体肾脏捐献者，使用线性混合效应模型来分析每月和每年的供体数量，以分析捐赠的年际和年内变化。我们使用泊松回归来量化 2005 年前后每个季节的供体数量变化，按供受者关系和邮政编码家庭收入三分位数进行分层。
我们观察到 6 月、7 月和 8 月期间捐赠量呈夏季持续增长。这种增长在相关供体（发病率比 [IRR] 范围：1.12-1.33）和非相关供体（IRR 范围：1.06-1.16）中具有统计学意义，跨越了供体收入三分位数。
我们的研究结果表明，在所有收入三分位数中，非夏季月份的活体肾脏捐献率较低。需要采取干预措施，以解决非夏季季节的捐赠障碍，并促进全年的捐赠。由于《器官捐献休假法》为支持全年捐赠提供了坚实的基础，将该法律的规定扩大到联邦雇员之外，可能会减轻已确定的季节性障碍。
